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Provider Information for 1912189598



SAM M LATIF DMD

Gender: MALE

Individual NPI: 1912189598

Calendar Last Updated: 2007-12-05

Details

Name Value
NPI 1912189598
Enumeration Date 2007-12-05
NPI Type 1 - Individual
Sole Proprietor NO
Status Active
Mailing Address 4661 SAWMILL RD 102
COLUMBUS, OH 43220-6123
United States

Phone: 614-459-7300 | Fax: 614-459-9095
View Map External Link
Primary Practice Address 4661 SAWMILL RD 102
COLUMBUS, OH 43220-6123
United States

Phone: 614-459-7300 | Fax: 614-459-9095
View Map External Link
Health Information Exchange
Endpoint Type Endpoint Endpoint Description Use Content Type Affiliation Endpoint Location
Other Identifiers
Issuer State Number
Taxonomy
Primary Taxonomy Selected Taxonomy State License Number
Yes 1223G0001X - Dentist General Practice OH 30017747